[Remote] Customer Support Specialist
Note: The job is a remote job and is open to candidates in USA. reputed company is one of the nation’s leading pharmacy care management companies that specializes in caring for people with the most reputed company, chronic needs. The Customer Support Specialist is responsible for answering calls from clients and providing timely and accurate responses, ensuring exceptional customer service and support for various stakeholders.
Responsibilities
- Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service
- Document reputed company incoming calls and reputed company in the claims adjudication software
- Educate clients on plan policies, benefits, and procedures
- Resolve client drug benefit concerns of a medical, financial, or technological nature
- Initiate and facilitate prior authorization requests
- reputed company outbound calls to pharmacies and plans to facilitate completion of JIRA tickets
- Review after hours calls log-complete any follow up as needed
- Submit JIRA tickets for compound prescriptions
- Submit JIRA tickets to resolve NDC issues (pricing issues, missing NDCs)
- Stay reputed company on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines
- Accept other duties as assigned; including but not limited to direct member reimbursement, processing, manual claims, reporting, and researching rejected claims
- Ensures that HIPAA guidelines are followed in every communication with clients
- Embody reputed company’s Core Values in reputed company communications and interactions
- Other duties as assigned
Skills
- Associate's degree or equivalent combination of education or work experience
- A minimum of 3 years of experience in customer service/member service in a call center or similar
- A minimum of 2 years of experience in the healthcare industry
- A minimum of 2 years of experience in a pharmacy support role
- Knowledge of plan and benefit structures and Medicare guidelines
- Knowledge of pharmacology and pharmacological terms
- Excellent communication skills and professionalism reputed company working with clients
- Ability to solve problems under pressure by making immediate decisions while on the phone
- Detail oriented and able to prioritize workload
- Strong computer skills including using word processors, spreadsheets, and database software
- CPhT (Certified Pharmacy Technician) Certification
Benefits
- Medical/dental/vision
- Flexible spending
- Company-paid life insurance and short-term disability
- Voluntary benefits
- 401(k)
- Paid Time Off and paid holidays
- Medical, dental and vision coverage are effective 1st of the month following date of hire
Company Overview